The value of work: A case study

Written by

Mark Debus

clinical behavioral health specialist

May 02, 2018

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In a recent case, I helped an injured employee overcome anxiety and return to work. It turned out that going back to work was its own kind of cure. Ryan was off work due to a lower back injury. His claims examiner contacted me because Ryan was not following the course of physical therapy he needed and it was delaying his recovery. I talked with Ryan and learned that he was afraid of getting better and going back to work because he feared reinjury.

Staying off work was impacting his marriage and his role as a parent for his teenage children. He and his wife were having frequent arguments and he felt powerless in his marriage. The imbalance he felt in his marriage was affecting his kids, including their performance at school.

I asked Ryan to reset and focus on what could help him. He identified life and family goals including improving his marriage and reducing stress on his kids. I explained that the goals could be achieved if he returned to work and that the benefits of going back to work far outweighed the risk. After a few weeks of continuing coaching, he returned to physical therapy and was back working modified duty in a short period of time.

When I checked on him after he was back on the job, Ryan said that returning to work was the best thing for him. He said that he finally felt hopeful, useful, productive and more whole than he had felt in a long time. Feeling productive is important for any change. Going back to work helped Ryan retake control of his life.

In some situations, providing behavioral health expertise and psychosocial intervention for difficult workers’ compensation claims will remove factors holding an individual back from recovering, staying at work or returning to work. Assessment for psychosocial issues that an injured worker may be having is important. Personal psychosocial problems drive up cost and lost time on claims. A behavioral health specialist can help injured workers develop goals and coping strategies to address their stressors so they can focus on injury recovery and returning to work.

Common concerns from people who have a work injury include financial stress, caregiver burnout, childcare needs, interpersonal conflicts in the workplace, depression, anxiety, and relationship difficulties. Being injured at work and being off work exacerbate other problems in a person’s life. Claims examiners and nurses should look for stressors that might be causing delayed recovery. In the case I cited, all the work was Ryan’s. I just helped guide him. In my next blog, I will focus on some of the primary reasons that work is therapeutic.

Comments

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Georgia Hampton-Williams
May 02, 2018

Great article! I never thought about the psychosocial effect a work injury can have on a claimant in the way you described. Your article helped put it in perspective.

Good morning! Would suggesting an injured worker talk with a Behavioral Health specialist provide the avenue to add a pysch condition to the claim. In Ohio when that happen the IW never returns to work. Thoughts?

The behavioral health specialist consults with the claims examiner before any contact is made with an injured worker to determine any potential jurisdictional issues or concerns that contact might have on the management of the claim. In Ohio, the examiner would refer the employee back to their physician of record to discuss their concerns about returning to work and allow their doctor to determine if behavioral health support is needed.

Behavioral health consists of telephonic discussions with an injured worker with a focus on listening, advocacy and coaching – all with the aim of helping the injured worker become more engaged in their own recovery and return to work planning. It is not considered psychotherapy or treatment.